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• A toddler may be restrained in the parent’s
lap, facing the parent, with the head turned to 1 side and pressed
up against the parent’s chest.

• The parent then gives the child a bear hug, wrapping 1 arm around
the patient’s body and arms and the other arm restraining
the head.

• It is important that the head be fully turned because the child
has less strength in this position to break free from the parent’s
grasp.

• An older child should be placed supine on the examining table,
with the head turned so that the affected ear is facing up.

• Immobilization of the head by an assistant is recommended, even
if the child appears cooperative.

• The inner two-thirds of the external auditory canal is exquisitely
sensitive to pain. With even minor manipulation, the child may suddenly
jerk his or her head, causing trauma to the external auditory canal.

• If the child is uncooperative, the shoulders and torso need to
be restrained as well.